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<div class=WordSection1>

<p class=MsoNormal align=right style='text-align:right'><span style='font-size:
10.0pt'>Форма № 03<o:p></o:p></span></p>

<p class=MsoNormal align=center style='text-align:center'><b style='mso-bidi-font-weight:
normal'><span style='font-size:18.0pt'>ОПИСЬ ЛИЧНОГО ДЕЛА №<o:p><?php echo $abiturient['Abiturient']['id'];?></o:p></span></b></p>

<p class=MsoNormal align=center style='text-align:center'><b style='mso-bidi-font-weight:
normal'><span style='font-size:18.0pt'>по регистрационному журналу<o:p></o:p></span></b></p>

<p class=MsoNormal align=center style='text-align:center'><b style='mso-bidi-font-weight:
normal'><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></b></p>

<p class=MsoNormal style='line-height:150%'><span style='font-size:14.0pt;
line-height:150%'>Фамилия <?php echo $abiturient['Abiturient']['lastname']; ?> Имя <?php echo $abiturient['Abiturient']['firstname']; ?><o:p></o:p></span></p>

<p class=MsoNormal style='line-height:150%'><span style='font-size:14.0pt;
line-height:150%'>Отчество <?php echo $abiturient['Abiturient']['surname']; ?><o:p></o:p></span></p>

<p class=MsoNormal style='line-height:150%'><span style='font-size:14.0pt;
line-height:150%'>Факультет <o:p>  <?php 
    echo $facultets[$profession['Profession']['facultet_id']];
   ?></o:p>
</span> </p>

<p class=MsoNormal style='line-height:150%'><span style='font-size:14.0pt;
line-height:150%'>Специальность <o:p>
<?php 
	echo $professions[$profession['Profession']['id']] ;
   ?>
</o:p></span></p>

<p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>

<table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0
 style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt;
 mso-yfti-tbllook:480;mso-padding-alt:0cm 5.4pt 0cm 5.4pt'>
 <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt'>
  <p class=MsoNormal align=center style='text-align:center'><b
  style='mso-bidi-font-weight:normal'><span style='font-size:14.0pt'>№№ <span
  class=GramE>п</span>/п<o:p></o:p></span></b></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border:solid windowtext 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt'>
  <p class=MsoNormal align=center style='text-align:center'><b
  style='mso-bidi-font-weight:normal'><span style='font-size:14.0pt'>Наименование
  документа<o:p></o:p></span></b></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border:solid windowtext 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt'>
  <p class=MsoNormal align=center style='text-align:center'><b
  style='mso-bidi-font-weight:normal'><span style='font-size:14.0pt'>Дата
  изъятия и место нахождения документов<o:p></o:p></span></b></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border:solid windowtext 1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt'>
  <p class=MsoNormal align=center style='text-align:center'><b
  style='mso-bidi-font-weight:normal'><span style='font-size:14.0pt'>Дата
  возврата документов в личное дело<o:p></o:p></span></b></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:1;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
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  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>1.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>Заявление<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
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  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:2;height:118.7pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:118.7pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>2.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:118.7pt'>
  <div style='mso-element:para-border-div;border:none;border-bottom:solid windowtext 1.5pt;
  padding:0cm 0cm 1.0pt 0cm'>
  <p class=MsoNormal style='border:none;mso-border-bottom-alt:solid windowtext 1.5pt;
  padding:0cm;mso-padding-alt:0cm 0cm 1.0pt 0cm'><span style='font-size:14.0pt'>
  <?php 
  if ($abiturient['Abiturient']['educationdoctype_id']) {
  	echo $educationdoctypes[$abiturient['Abiturient']['educationdoctype_id']];
	echo "<br />";
	echo $abiturient['Abiturient']['educationdocdata'];
  } else {
  	echo 'Тип документа об образовании в деле не указан!';
  }
 
  ?> 
  <o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:118.7pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:118.7pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:3;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>3.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>Мед<span class=GramE>.</span>
  <span class=GramE>с</span>правка 086-у<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:4;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>4.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>4 фотографии<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:5;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>5.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>Выписка из трудовой книжки<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:6;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>6.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>Договор<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:7;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>7.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>Целевое направление<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:8;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>8.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>Копия паспорта<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:9;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>9.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'>Копия свидетельства ЕГЭ<o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:10;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>10.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p></o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
 <tr style='mso-yfti-irow:11;mso-yfti-lastrow:yes;height:36.85pt'>
  <td width=45 valign=top style='width:33.7pt;border:solid windowtext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal align=center style='text-align:center'><span
  style='font-size:14.0pt'>11.<o:p></o:p></span></p>
  </td>
  <td width=274 valign=top style='width:205.55pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=160 valign=top style='width:119.65pt;border-top:none;border-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:36.85pt'>
  <p class=MsoNormal><span style='font-size:14.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
 </tr>
</table>

<p class=MsoNormal><o:p>&nbsp;</o:p></p>

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